Kant Ashima K, Graubard Barry I
Department of Family, Nutrition, and Exercise Sciences, Remsen Hall, Room 306E, Queens College of the City University of New York, Flushing, NY 11367, USA.
J Am Coll Nutr. 2005 Aug;24(4):294-303. doi: 10.1080/07315724.2005.10719477.
Examination of dietary indexes in association with objective biomarkers of dietary intake and chronic disease risk is an important step in their validation. We compared three dietary pattern indexes-Healthy Eating Index (HEI), Recommended Foods Score (RFS-24 hour recall), and Dietary Diversity Score for recommended foods (DDS-R)-for their ability to predict biomarkers of dietary intake, obesity, cardiovascular disease, and diabetes.
We used dietary and laboratory data from the third National Health and Nutrition Examination Survey to study these associations in 8719 disease-free adults aged > or =20 y. The HEI, developed by the USDA, was a sum of scores on consideration of ten individual components; the RFS was a sum of all recommended foods (lean meat, poultry and fish, whole grains, fruits and juices, low-fat dairy, and vegetables) mentioned in the recall; the DDS-R examined whether or not a recommended food was mentioned from each of the five major food groups. The independent association of the dietary pattern indexes with body mass index (BMI), blood pressure, and serum concentrations of several biomarkers were examined using regression methods to adjust for multiple covariates.
All indexes were strong independent positive predictors of serum concentrations of vitamin C, E, folate, and all carotenoids (p < or = 0.00001), except lycopene, and were negative predictors of BMI, serum homocysteine, C-reactive protein, plasma glucose, and hemoglobin A1C (p < 0.05). The RFS and DDS-R were inversely associated with blood pressure and serum cholesterol (p < or = 0.03).
The RFS and DDS-R performed as well or better than the HEI for predicting serum concentration of nutrients and biomarkers of disease risk.
检验饮食指数与饮食摄入及慢性病风险的客观生物标志物之间的关联是对其进行验证的重要一步。我们比较了三种饮食模式指数——健康饮食指数（HEI）、推荐食物得分（基于24小时回忆法的RFS）和推荐食物饮食多样性得分（DDS-R）——预测饮食摄入、肥胖、心血管疾病和糖尿病生物标志物的能力。
我们使用第三次全国健康与营养检查调查中的饮食和实验室数据，对8719名年龄≥20岁的无病成年人进行这些关联研究。美国农业部制定的HEI是考虑十个个体成分后的得分总和；RFS是回忆中提到的所有推荐食物（瘦肉、家禽和鱼类、全谷物、水果和果汁、低脂乳制品以及蔬菜）的得分总和；DDS-R考察了是否从五个主要食物类别中提及了一种推荐食物。使用回归方法调整多个协变量，检验饮食模式指数与体重指数（BMI）、血压以及几种生物标志物血清浓度之间的独立关联。
除番茄红素外，所有指数都是血清维生素C、E、叶酸和所有类胡萝卜素浓度的强独立正向预测因子（p≤0.00001），并且是BMI、血清同型半胱氨酸、C反应蛋白、血糖和糖化血红蛋白A1C的负向预测因子（p<0.05）。RFS和DDS-R与血压和血清胆固醇呈负相关（p≤0.03）。
在预测营养素血清浓度和疾病风险生物标志物方面，RFS和DDS-R的表现与HEI相当或更佳。
